Effects of different fissure sealant applications on laser fluorescence measurements

Effect of pit and fissure sealants on caries detection by a fluorescent camera system

OBJECTIVE

The aim of this study was to evaluate the effect of sealant placement on the detection of caries by a fluorescent camera (FC), the Spectra caries detector.

MATERIALS AND METHODS

In a laboratory study, FC images and readings were obtained from 31 extracted teeth, before and following application of clear sealants (Shofu Clear or Delton unfilled), or opaque sealants (3M Clinpro or Delton FS). Teeth were then sectioned and examined for enamel or dentine caries. Using each tooth's true caries diagnosis, the sensitivity and specificity of the FC measurements in detecting dentine caries was calculated. In the clinical study, FC readings were obtained from 41 molars in children prior to and following application of clear sealants.

RESULTS

Following application of Shofu or Delton unfilled there were reductions in the mean FC readings of 10% (p=0.5) and 8.2% (p=0.009), respectively. Application of two opaque sealants, 3M or Delton FS significantly reduced mean FC readings 16.2% and 20.8% (p<0.5), respectively. Although the carious lesions could still be observed in FC images from teeth with opaque sealants there was a significant loss of sensitivity in detecting dentinal caries. Clear sealant application caused an insignificant loss of detection sensitivity. Following application of clear sealants to children's molars there was a small (4.01%) but significant (p<0.01) reduction in FC readings recorded from these teeth.

CONCLUSIONS

The FC can detect caries under clear sealants with little loss of sensitivity. Although lesions can be seen through opaque sealants, loss of sensitivity precludes accurate lesion assessment.

The effect of fissure sealants on the values of two different caries detection devices

OBJECTIVE

The aim of this in vitro study was to evaluate the effects of clear and opaque fissure sealants on readings of laser fluorescence (LF) and light-emitting diode (LED) based caries detection devices.

BACKGROUND DATA

When planning patient care, the practitioner needs to consider any changes in the status of the sealed surface for the long-term success of the sealant. As visual inspection is difficult to perform on sealed surfaces, adjunct diagnostic methods must be used to improve follow-up assessments and increase the accuracy of caries diagnosis.

METHODS

Forty-six freshly extracted permanent human molars were selected and divided into two groups. Each group was treated with a different sealant (clear and opaque). The teeth were measured twice by two blinded observers using an LF-based and an LED-based device before and after sealing. The data were analyzed using Wilcoxon's matched-pairs signed-rank test and a paired t-test. Cohen's κ and the intraclass correlation coefficient were used to examine intra- and inter-examiner repeatability.

RESULTS

The values of the LED device were significantly higher after the application of the opaque sealant, but there was no statistically significant difference after the application of the clear sealant (p=0.15). The LF-based device readings were also significantly lower after both the clear and the opaque sealant applications (p<0.001).

CONCLUSIONS

The readings from the LF-based device were affected by both sealants. The readings from the LED-based device were affected by the opaque sealant but not by the clear sealant.